Addressing Underinvestment in NHS Community Services

A new survey has exposed the stark reality of underfunding in NHS community services, highlighting the urgent need for greater investment to support high-quality care closer to home

CREDIT: This is an edited version of an article that originally appeared in NHS Confederation

A survey conducted by the Community Network earlier this year has highlighted the significant underinvestment in NHS community services, revealing the challenges faced by community providers in securing adequate capital funding.

Community healthcare services play a crucial role in delivering care throughout people’s lives, from health visiting and paediatric support to urgent community response, virtual wards and frailty services. Despite being responsible for 13 percent of all daily NHS activity and accounting for a fifth of the NHS workforce, community providers continue to struggle with insufficient resources.

Lack of Access

One of the most pressing concerns is the lack of access to national capital funding, particularly for community interest companies (CICs). While capital funding remains a challenge across all sectors of the NHS, community providers are often left out of central funding allocations, which tend to prioritise hospitals. This imbalance hinders the ability of community services to provide high-quality care in the most appropriate settings, limiting their potential to alleviate pressure on acute hospital services and improve patient outcomes.

The survey findings reflect the widespread frustration among community providers. A staggering 87.5 percent of respondents disagreed with the statement that their organisation can secure adequate capital funding. Every respondent stated that they lacked the capital necessary to facilitate the shift towards more community-based care. Additionally, 92 percent expressed concerns that they did not have sufficient resources to support the transition from analogue to digital systems or to focus on preventive care rather than reactive treatment.

Many respondents emphasised the need for long-term government planning to make better use of existing NHS estates. Nearly four-in-five respondents agreed that targeted capital investment and the flexibility to explore alternative funding routes would be essential in addressing these challenges.

Strategic Priorities

The report outlines key strategic priorities to help integrated care systems. To fulfil the government’s commitment to moving more care into community settings, the Department of Health and Social Care and NHS England must prioritise capital and revenue investment in technology and estates for community health services. Additionally, there is an urgent need to review and increase capital department expenditure limits (CDEL) to ensure adequate resources are available for these services. The current regulations governing how NHS trusts enter leases should also be reviewed to provide greater flexibility in leveraging existing estates. Allowing providers to lease properties in partnership with other organisations would enable more effective colocation and create adaptable, community-based healthcare hubs.

For practice managers, these findings are particularly significant. They highlight the systemic barriers that limit their ability to expand services, improve patient care and integrate more innovative healthcare solutions. Without access to adequate funding, practice managers may struggle to provide the level of service their patients require, ultimately placing additional strain on already stretched resources.

The report serves as a critical call to action for policymakers to ensure that community healthcare services receive the investment they need. As the NHS continues its transformation, it is vital that funding mechanisms evolve to support care closer to home. For practice managers and community healthcare leaders, advocating for these changes is essential to securing the resources necessary for a more sustainable, patient-centred future.